| NPI | 1477823086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME CC4325) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: ME XL3834) |
| 101YP2500X Counselor Professional (Licence: WI 1636-226) | |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2017-04-20 |